Women whose breakouts are associated with their menstrual cycle usually find that they get pimples or blackheads about two to seven days before the start of their period. That problem tends to go away after menopause, so you can look forward to some relief! However, you may still break out occasionally during the transition.
Fluctuating hormones could indeed be the problem. Although doctors don’t really understand what causes acne, they do know that an increase in androgens (male sex hormones) is an important factor. And, as you know, you do experience a change in the estrogen-androgen ratio during the menopause transition. In studies, women who had acne have higher levels of circulating androgens than women without acne. Similarly, women who had acne during adolescence also often get it again at midlife. Other possible causes: greasy makeup, medications (such as lithium for bipolar disorder or barbiturates used to control seizures) and even resting your cheek on your hand (a source of bacteria).
Contrary to myth, chocolate, fried foods, and dirty skin do not cause acne. Neither does stress, but it can aggravate acne, so try to relax more.
If pimples are really troubling you, try over-the-counter acne medications containing benzoyl peroxide, resorcinol, salicylic acid, or sulfur. These break down blackheads and whiteheads and reduce oil production in your skin. But don’t slather them on as you might have done when you were a teenager. Put the medication just on the spot—not on the area around it. Your skin is drier now, so you need to be careful. You should look for products made for adults, including some specifically formulated for menopausal women.
If you’re still not getting relief, see a dermatologist for antibiotics or other prescription medication. Oral contraceptives and menopausal hormone therapy may also help.
In the meantime, wash your face gently; don’t scrub or rub it. That will only exacerbate the problem.
Most of the controversy over hormone therapy at menopause has centered on the risks of cancer and heart disease. But many women who use estrogen say they like it because it makes them look younger. What’s the science behind their claims? Estrogen therapy does not alter the effects of genetic aging, and it can’t reverse the damage from sun exposure or smoking.
It has no effect on the risk of skin cancer. But clinical trials have shown that systemic estrogen may have some benefits for skin. It appears to limit collagen loss, maintain skin thickness, improve firmness and elasticity, and decrease wrinkle depth and pore size. Researchers say the data aren’t convincing enough to recommend taking estrogen for this reason alone and it’s not FDA-approved for this purpose.
Research is ongoing.